Products & Services Innovations for Functional Therapy Solutions We move you
Hocoma - Moving You Toward Successful Rehabilitation Improving patients lives has always been our goal. This simple goal is the driving force behind, and the compass by which we base our actions. That s our recipe for success. Focusing on patient needs, preserving our entrepreneurial spirit, and driving innovation has transformed Hocoma from a pioneer in the field of functional movement therapy to the world leader with its game-changing advancements and solutions. From One Big Idea to Market Leader in Neurorehabilitation It all started back in the 90s when three friends, the economist Peter Hostettler (Ho) and the electrical and biomedical engineers Gery Colombo (Co) and Matthias Jörg (Ma) had the idea to start a business. As a pioneering company, we broke new grounds, overcame obstacles and shaped a new era of robotic rehabilitation. Today we still develop cutting-edge medical rehabilitation devices that focus on the evolving needs of patients, therapists and societies and improve the lives of people around the world. Trusted by the world s leading rehabilitation and research centers, we provide solutions for the challenges of functional movement therapy, from very early inpatient treatment to late phase outpatient treatment and beyond. Our solutions are easily accessible as a complete setup in one place, making therapy a pleasant experience, both for patients and therapists, by providing: 1 intensive locomotion therapy (Lokomat ) 2 functional therapy of the upper extremities (Armeo ) 3 patient mobilization in early rehabilitation programs (Erigo ) 4 functional over-ground gait therapy with dynamic body weight support (Andago ) 5 functional movement therapy for lower back pain treatment (Valedo Therapy Concept) 1 2
Our entrepreneurial spirit and innovative strength has been awarded with numerous technology and entrepreneur prizes, including the Ernst & Young Entrepreneur of the Year award, Red Herring Global and the Swiss Technology Award. Strong Partnerships for Innovative Solutions To truly understand the individual needs of patients, we develop all of our therapy solutions in close cooperation with leading hospitals, universities and research centers. The relationship with our worldwide clinical network transforms visions into effective solutions and is key to our success. Thanks to our partners, we are able to create innovative solutions for patients, gain insight to their needs and support effective and efficient rehabilitation. Together we can enhance rehabilitation, ensure a cross-disciplinary knowledge transfer and work on the further acceptance and establishment of robotic rehabilitation. Worldwide Services We work closely with a wide network of highly qualified partners in more than 60 countries worldwide to offer our customers a wide range of services and the best possible experience by providing the following. Technical Service Our team of dedicated technicians is always by your side when it comes to any technical or software issues, maintenance, warranty and upgrades - online and on-site. Additionally, the Service Help Desk is the first point of contact in case of any technical issues or requests and is available 24/7. Clinical Training We offer in-depth training and extensive product documentation to all our Hocoma device users. User workshops, interest groups and continuous support by our clinical specialists keep you up to date. Clinical Research & Education Numerous independent scientific studies have proven the efficacy and efficiency of robotic rehabilitation. For those who are interested in or who are already working with our devices, we have created the Hocoma Knowledge Platform. This valuable and unique database helps you keep abreast of the latest scientific publications on Hocoma products, offers an interactive exchange of experiences and a free flow of information in all areas of modern rehabilitation. We Move You We have currently more than 170 employees globally, who work at our headquarters near Zurich and at our subsidiaries in the USA, Singapore and Slovenia. We are a truly international company and employ people from 25 different countries who enrich the Hocoma team with their knowledge, ideas and enthusiasm. Since our founding, we have been dedicated to providing patient-centered and user-friendly solutions that improve the quality of life of patients and empower therapists worldwide. Whether your goal is to provide more effective therapy, efficiently use your therapy resources or to seamlessly integrate the most innovative rehabilitation technologies into your clinical workflow, our global network is there to meet your needs. 3 5 4 Hocoma Portfolio 3
Patient Story Philipp Bryant Wait Until I Get Back Up And Running. Just Wait! After a serious car accident, Philip had a T10 complete spinal cord injury, Asia A, with nine fractured vertebrae and a spine fusion from T7 to L4. But this life-changing injury did not stop him. After I got home, I bought parallel bars and braces online and just went for it!" He worked tirelessly, day and night until he was finally able to stand and take a few steps supporting himself on the parallel bars. That was when his doctor prescribed him 16 therapy sessions with the Lokomat. After the second therapy session, Phillip started to feel his calf muscles pulsating. I couldn t explain it, but I felt that it was doing something good, he says. I fell in love with the Lokomat that day! Despite being told he would never walk again, Philipp experienced great initial therapy success. I noticed that my steps had become easier, explains Phillip. I ve continued home therapy in addition to the Lokomat and now I m doing leg presses pushing 30 pounds! And his hard work is benefiting not only himself, but also those closest to him. The reward for never giving up and never losing hope that he would indeed regain his ability to stand and walk? Phillip was able to stand on the beach as the best man at his best friend's wedding. 4 Hocoma Portfolio
Lokomat Robotic Gait Therapy Lokomat therapy means efficient, high-intensity gait training aimed at restoring a physiologically correct gait pattern while walking. It enables you to treat more patients and to increase independence in walking. Scientifically proven to enhance therapy outcomes and trusted by rehabilitation centers worldwide, it supports, challenges and motivates your patients. About the Lokomat The Lokomat assists walking movements of gait-impaired patients and is used to improve mobility in individuals following stroke, spinal cord injury, cerebral palsy as well as other neurological diseases and injuries. Advantages of Gait Therapy with the Lokomat Pro NEW FreeD Module: Further improves therapy by supporting weight shifts and balance activation through lateral and rotational movements of the pelvis. NEW Challenge Package: Supports specific therapy goals to optimally challenge your patients. Longer and more intensive training sessions compared to manual treadmill training. Augmented Performance Feedback for higher motivation and compliance. Physiological gait pattern provided by individually adjustable orthoses, guidance force and body weight support. Assessment and reporting functionality for easy measurement of the patient s progress. Pediatric Orthoses: An add-on module offering a gait orthosis for the therapy of small children. Clinical Studies By the end of 2015 more than 250 studies had already been published on Lokomat therapy in peer-reviewed journals, making it the most cited device for lower extremity rehabilitation. Find all Lokomat studies published by peer-reviewed journals at knowledge.hocoma.com COCHRANE REVIEW 2013 Experience the Lokomat at hocoma.com/lokomat Lokomat Product Line Lokomat Nanos Lokomat Pro Functional Support Robotic gait orthoses for adults Augmented Performance Feedback Robotic gait orthoses for children accessory Assist-as-needed support basic advanced Dynamic body weight support Training programs Automatic gait variation Manual treadmill training FreeD module for pelvis movement accessory Biofeedback basic advanced Challenging therapy exercises User Interface Intuitive touch screen user interface Assessments and Reporting Assessment tools Recorder tool Reporting tool Hocoma Portfolio 5
Effective gait training for little patients To adapt Lokomat therapy to treat children with cerebral palsy, stroke, traumatic brain injury, spinal cord injury and other neurological diseases and injuries, we ve developed special orthoses for children and adolescents together with the Children s Rehabilitation Center in Affoltern, Switzerland. The pediatric orthoses feature special belts and cuffs to fit the patients thigh from 21 cm, and ensure their comfort. Lokomat with orthoses for children is used in day-to-day clinical practices in numerous rehabilitation centers and children s hospitals all over the world. It is therefore possible to offer intensive and effective gait training to children as they explore fun, child-oriented virtual worlds through the Augmented Performance Feedback exercises. The Advantages of Therapy with the Lokomat Pro Scientific evidence shows that Lokomat training improves the outcome of physical therapy. 1,2 Therapists can provide more treatment sessions with higher intensity. The individually adjustable exoskeleton ensures a physiological gait pattern with essential sensory feedback. Assist-as-needed support enables clinicians to optimally shape the training challenge based on the patient s capabilities. Exciting, game-like Augmented Performance Feedback exercises increase the patient s motivation and effort. 1 By the end of 2015 more than 250 studies have been published on the Lokomat therapy in peer reviewed journals. Please find a detailed list online at http://knowledge.hocoma.com 2 Mehrholz J, Elsner B, Werner C, Kugler J, Pohl M. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2013 Jul 25;7:CD006185.
Lokomat Pro with FreeD The new FreeD module further improves the therapy by supporting weight shifts and balance activation through lateral and rotational movements of the pelvis. The Lokomat is an ideal addition to inand outpatient rehabilitation programs and for long-term care facilities. The FreeD Module Available as a module for the LokomatPro, FreeD improves the therapy by allowing for lateral translation and transverse rotation of the pelvis (fig. 1). While training, patients can shift their weight completely over their stance leg and thereby activate their core muscles and experience balance aspects. This is crucial in the relearning of independent walking. The passively guided hip abduction and adduction as well as the driven lateral translation of body weight support are fully synchronized with pelvis movements and the movement of the orthoses. Fig. 1a Fig. 1b Fig. 1c Lateral translation Transverse rotation The new FreeD module allowing for lateral and rotational movements of the pelvis. Courtesy of LKH Hochzirl, Austria. Fig. 1: Adjustable lateral translation of up to 4 cm (fig. 1a) and transverse rotation of the pelvis of up to 4 (fig. 1c) to each side during walking (fig. 1b). Challenge Package The Challenge Package of the LokomatPro offers highly attractive exercises that boost the patient s motivation and effort by providing competitive elements and intuitive scoring. The Augmented Performance Feedback explicitly rewards the patient for improvements in specific aspects of functional gait training such as foot clearance and step length. Even severely affected patients who still require full guidance can profit from the option to increase kinematic variability, which is beneficial for the relearning process. The new Challenge Package exercises improve the patient s long-term motivation by unlocking new levels with different designs. Stroke patient optimally motivated by racing against a virtual opponent with the new Challenge Package. The advanced exercise allows the patient to actively increase his walking speed by putting in more effort, resulting in higher training intensity. Courtesy of LKH Hochzirl, Austria. Hocoma Portfolio 7
NEW To facilitate the progression from highly intensive Lokomat robot-aided gait training to training overground for best skill transfer to daily life, we need tools that are extremely flexible. The Andago offers that flexibility and ease of use and I like its versatility, which should allow us to optimally prepare our patients for the wide variety of environments and challenges they need to master in everyday activities. Alberto Esquenazi, MD Chief Medical Officer, MossRehab, USA 8 Hocoma Portfolio
Andago New Perspectives in Functional Gait Therapy Feel innovation. Andago opens up new perspectives in functional gait therapy with dynamic body weight support. Safe, mobile and versatile training for the path back toward independent living. Andago is a mobile robot for body weight supported gait training that allows upright, hands-free walking without spatial limitations. It bridges the gap between treadmill-based gait training and free walking, and offers a safe and functional environment. Physiological Training: Walking Naturally as Andago Actively Follows The dynamic body weight support and the mobile robotic platform of Andago enable a physiological, upright posture during training. Patients train hands-free and can concentrate on walking itself while the Andago follows them intuitively for a safe and unhindered training. Confident Focus on Walking: Reach Your Goals Safely Fall protection and intuitive patient-following ensure a safe training for patient and therapist at all times. The patient trains confidently while the therapist can focus on delivering an optimally challenging therapy session. The therapist can adjust the intensity and challenge for the patient by selecting different training modes. Versatile Training with High Mobility: Choose Your Own Path The compact dimensions of Andago allow for a versatile training that supports step training and offers high mobility. Patients can move from room to room in a self-directed way as an ideal preparation for everyday life. Seamless Clinical Integration: Use Straight Out Of The Box Andago requires no installation or building modification. Its intuitive workflow allows for a quick and easy therapy start and a simple integration into the clinical routine. Objective Training Documentation: Share Your Success Clear display of key training results and an easy export of these data via a USB drive provide thorough documentation of the training progress for clinical decision-making as well as for health insurance providers. See Andago in action at www.hocoma.com/andago. Example parcours in a corridor Hocoma Portfolio 9
Patient Story Hans-Jürgen Bischofs Training is Great Fun After a stroke, Mr. Bischofs has been visiting the Therapy Center in Osnabrück twice a week for three weeks and it is here, that his progress is picking up speed. His aim was to work on his arm s motor abilities and to be able to use it again in everyday life. I like the feedback that I get from the ArmeoSpring a lot. Although the training is challenging, it s also great fun and after only a few training sessions I can actively use my arm again. The Armeo Therapy Concept: Covering the Whole Continuum of Upper Extremity Rehabilitation Armeo Power Robotic arm exoskeleton Early rehabilitation with highly repetitive training for severly affected patients Six actuated degrees of freedom for training in an extensive 3D workspace Assist-as-needed support from full guidance to self-initiated active movements Armeo Spring Exoskeleton with spring mechanism Self-initiated, active movement therapy for severe-to-moderate patients Simultaneous arm and hand rehabilitation in an extensive 3D workspace Pediatric Version ArmeoSpring, specifically designed and built for children Armeo Boom Overhead sling suspension system Self-initiated, active movement therapy for moderately affected patients Arm Weight Support with low inertia for free movements in a 3D workspace Can be easily and independently operated by the patient Specificially designed for use in outpatient centers 10 Hocoma Portfolio
Armeo Therapy Concept Arm and Hand Therapy The Armeo Therapy Concept combines the world s most widely used advanced arm and hand rehabilitation product line and has enabled many patients to regain function after a neurological injury. It is a clinically effective therapy solution, which increases the intensity of rehabilitation, with more repetitions at a higher active patient effort. About the Armeo The Armeo Therapy Concept s main feature and advantage over the classic therapy is the arm and hand support system that helps patients get motivated from within and thus rely less on the therapist. Clinical Advantages of the Armeo Therapy Concept A modular therapy concept for the whole Continuum of Rehabilitation", covering the therapy goals of all patients, from the beginning of the rehabilitation progress through to home therapy. Arm Weight Support in an extensive 3D workspace. Augmented Performance Feedback with motivating exercises to train activities of daily living. Repetitive training of goal-oriented movements. Improved therapy efficiency and patient care. Assessment Tools for an objective analysis and documentation of the patient s progress. Motor function Injury Function regained earlier Armeo therapy Standard therapy ArmeoPower ArmeoSpring ArmeoBoom Clinical Studies Our product development builds on close cooperation with leading clinics and hospitals worldwide and is based on current results in medical research. Find all Armeo studies published by peer-reviewed journals at knowledge.hocoma.com Improved therapeutic outcome The Armeo Therapy Concept covers the whole "Continuum of Rehabilitation". Time Experience the Armeo line at hocoma.com/armeo Armeo Therapy Concept Armeo Power Armeo Spring & Pediatric Armeo Boom Functional Support Arm Weight Support in 3D Workspace Exoskeleton for movement guidance Grasp and release module (Manovo) robotic spring-based Assist-as-needed support Mobilization Augmented Performance Active range of motion exercises Feedback Strength and endurance exercises Selective control of joints in exercises Grasp and release exercises Assessment and Assessment tools advanced standard basic Reporting Reporting tools advanced advanced basic Hocoma Portfolio 11
Stroke Patient Story Daniel Petithuguenin Returning to Daily Life After an ischemic stroke damaged a part of the right side of his brain, Mr. Petithuguenin had light paresis and a left-sided ataxia. During the 20 days he spent at the Centre Hospitalier Universitaire Vaudois (CHUV) he trained with the Erigo and received both physical and occupational therapy that helped him improve his coordination and movement control. Regaining some of his independence, Mr. Petithuguenin was able to return home with his wife and actively participate in daily life again. "We note a direct link between the sensorimotor stimulation of the Erigo during therapy and the recovery process of our neurological patients", explains Dr. Karin Diserens, Head of Unit of Acute Neurorehabilitation and specialist in neurology and neurorehabilitation at the CHUV.
Erigo Innovation for Early Rehabilitation Programs The ErigoPro further improves mobilization of patients with circulatory, neurological, or musculoskeletal conditions by supporting the stimulation of the patient with its integrated Functional Electrical Stimulation (FES). The ErigoPro is the ideal addition to acute care early rehabilitation programs and offers further benefits and therapy options in the clinical routine. About the Erigo Functional electrical stimulation (FES) is an established method for targeted muscle activation. By adhering electrodes to the skin, nerve endings are stimulated with electricity causing a contraction and activation of muscles that cannot be controlled actively due to a neurological dysfunction. Combined with cyclic movement training, the Erigo FES efficiently supports the increase of blood flow in the patient s lower extremities, which helps to maintain stroke volume and blood pressure, thereby further improving the orthostatic tolerance during early verticalization. 1 It has also been shown that therapy with FES improves cerebral blood flow and muscle strength in lower extremities. 2 This can specifically support recovery of leg muscle function. Advantages of Early Rehabilitation with the Erigo Pro Increased tolerance to an upright or standing position Maintaining or increasing range of motion Relaxation of muscle spasms Prevention or retardation of disuse atrophy Increasing local blood circulation Clinical Studies Our product development builds on close cooperation with leading clinics and hospitals worldwide and is based on current results in medical research. Find more Erigo studies published by peer-reviewed journals at knowledge.hocoma.com Experience the Erigo at hocoma.com/erigo Erigo Product Line Erigo Basic Erigo Pro Functional Support Progressive verticalization up to 90 Cyclic leg loading Erigo FES (by Hasomed ) Hip extension function Selection of different movement patterns Patient Interface Height adjustment for patient transfer Flexible patient harness Head elevation function Armrests accessory User Interface Full therapy control via intuitive user interface Intelligent leg loading indicator 1 Yoshida T et al (2013). Cardiovascular Response of Individuals With Spinal Cord Injury to Dynamic Functional Electrical Stimulation Under Orthostatic Stress. IEEE Trans Neural Syst Rehabil Eng 21(1):37-45. 2 Kuznetsov AN, Rybalko NV, Daminov VD, Luft AR (2013). Early poststroke rehabilitation using a robotic tilt-table stepper and functional electrical stimulation. Stroke Res Treat. 2013;2013:946056. Hocoma Portfolio 13
Patient Story Marian Keller Regaining the Lust for Life After reading about the Valedo, Marian decided to look for a clinic that offers this therapy in her area. "I was diagnosed with Multiple Sclerosis 38 years ago", Marian explains. "Over the years I acquired some really bad movement patterns. I had difficulty walking and always had to plan well when I was going someplace I didn t know yet." After training with the ValedoMotion once a week for a month, Marian already noticed strong improvements. "It didn t only improve my mobility but it also increased my lust for life!" Motivated by the therapy and the improvement she sees and feels, Marian looks forward to continuing therapy at home with Valedo. 14 Hocoma Portfolio
Valedo Therapy Concept For a Healthy Back The ValedoShape, ValedoMotion and Valedo are complementary solutions for a healthy back and offer a continuous solution from spine assessment to therapy in the clinic and at home. The Valedo Therapy Concept is the ideal addition to back pain treatment offering clinical assessments and functional exercise training. For a Healthy Back At Home and at the Clinic The ValedoShape is a non-invasive assessment device for an accurate analysis of the spine. It documents the therapy progress rapidly and precisely, which is crucial for deciding on a suitable and efficient course of therapy. The ValedoMotion enhances back therapy using innovative sensor technology. It assists therapists in improving their patients motor control and movement awareness. Valedo is an ideal and reliable tool for enhancing the treatment of patients suffering from back pain and helps to redevelop back muscles. The effective and motivating exercises improve patient compliance, and the mobile and portable design allow patients to complete exercises at home, work and even when traveling. Experience the Valedo Therapy Concept at hocoma.com/valedo Advantages for Therapists Clinical assessments and reporting Correct movement compliance Track and document therapy progress Other benefits from the Valedo business model Valedo Shape Innovative spine assessment Valedo Motion Professional tool for medical, motivating back therapy Valedo Therapeutic exercises through fun gaming Advantages for Patients Increased motivation and therapy compliance Higher number of repetitions with correct and safe movements Maximization of therapy potential Clinical Studies Our product development builds on close cooperation with leading clinics and hospitals worldwide and is based on current results in medical research. All devices in the Valedo Therapy Concept were recently certified and recommended by the German Campaign for Healthier Backs: www.agr-ev.de Valedo Product Line Valedo Shape Valedo Motion Valedo Augmented Performance Motivation through game-like exercises Feedback Real-time feedback Simple to complex movements basic Multiple therapy positions Assessment and Spine measurement Reporting Display of spinal shape and mobility Assessments & Visualization Patient report on exercise performance Clinical report on therapy progress basic User Interface Configuration for personalized treatment Different therapy goals basic Hocoma Portfolio 15
Hocoma is the global market leader providing the most advanced solutions for functional movement therapy. Hocoma Hub Sales Partners & Direct Sales Headquarters Hocoma Switzerland Tel. +41 43 444 2200 info@hocoma.com Hub Europe East Hocoma Slovenia Tel. +386 1 236 1330 info.slo@hocoma.com Hub North America Hocoma USA Tel. +1 877 944 2200 info.usa@hocoma.com Hub Asia Pacific Hocoma Singapore Tel. +65 6513 0580 info.sin@hocoma.com www.hocoma.com Product Disclaimer All Hocoma products are medical devices and must be used in strict adherence to the User Manual; failure to do so may result in serious personal injury. It is strongly recommended that you regularly consult Hocoma s website (www. hocoma.com/legalnotes) for the latest available information. Please contact Hocoma should you have any questions. Use only under the supervision of qualified medical personnel. However, certain Hocoma products are marketed for home use and must be strictly used according to the recommendations of your medical care provider who is knowledgeable about your specific needs. Consult the User Manual and Hocoma s website (www.hocoma.com/legalnotes) for appropriate product designation. Failure to obtain and follow the recommendations of your medical care provider may result in serious personal injury. This information provides details about medical products which may not be available in all countries and may not have received approval or market clearance by all governmental regulatory bodies throughout the world. Nothing herein should be construed as a solicitation or promotion of any product or of an indication of any specific use for any product which is not authorised by the laws and regulations of the country where the reader of this information resides. All content is subject to change without notice. Hocoma, CH-Company-141105 EN